This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

No abstract

Objectives: To determine accidental factors, clinical presentation and medical care in cases of seafarers presenting phosphine poisoning symptoms on board a bulk carrier. To consider primary prevention of this pathology, which can have extremely severe consequences. Methods: To analyse circumstances resulting in toxic exposure to phosphine in the sea transport sector. To obtain information from medical reports regarding the seafarer's rescue. To identify the causes of this accidental poisoning and how to establish an early, appropriate diagnosis thus avoiding other cases.Results: In February 2008, on board a bulk carrier with a cargo of peas, a 56-year-old seafarer with intense abdominal and chest pains, associated with dizziness, was rescued by helicopter 80 miles away from the coast. Despite being admitted rapidly to hospital, his heart rate decreased associated with respiratory distress. He lost consciousness and convulsed. He finally died of pulmonary oedema, major metabolic acidosis and acute multi organ failure. The following day, the captain issued a rescue call from the same vessel for a 41-year-old man also with abdominal pain, vomiting and dizziness. The ECG only revealed type 1 Brugada syndrome. Then 11 other seafarers were evacuated for observation. 3 showed clinical abnormalities. Collective poisoning was suspected. Medical team found out that aluminium phosphide pellets had been put in the ship's hold for pest control before the vessel's departure. Seafarers were poisoned by phosphine gas spreading through cabins above the hold. It was found that the compartments and ducts were not airtight. Conclusion: Unfortunately, a seafarer on board a bulk carrier died in 2008 because of acute phosphine poisoning. Fumigation performed using this gas needs to be done with extreme care. Systematic checks need to be carried out before sailing to ensure that the vessel's compartments are airtight.

Skin conditions are nearly universal in this maritime population. Further assessments are needed to know if long-term use of protective gear; improved hygiene; use of barrier creams; and proper on-board care of fungal infections, wounds, and burns could reduce the number and severity of skin problems encountered in sport sailors.

Background: The question we asked was whether it is worthwhile screening for seafarers who are prone to boredom, and whose mental health might deteriorate on board because of the particular character of life at sea. Materials and methods: We used the Farmer and Sundberg Boredom Proneness Scale (BPS), validated in French, as well as the Zigmond and Snaith Hospital Anxiety and Depression Scale (HADS). The survey was voluntary and responses were collected by means of questionnaires which were returned by post. Results: Eighty seafarers (40 officers and 40 crew) as well as 63 office staff from the same shipping company were included in the survey. We found a significant difference between officers and operational personnel: average score of 8.4 ± 5 (median = 7) for officers and 10.2 ± 4.8 (median = 10) for operational personnel. 21% of the officers have scores greater than or equal to 12 compared with 41% of the crew. There is a significant correlation between the BPS and HADS test scores, in terms of depression, for the office staff and the seafarers taken as a whole; this correlation being highly significant among officers (r = +0.85), but only marginally significant among crew members (r = +0.54). Conclusions: The BPS may be useful in screening for seafarers prone to boredom and depression for their fitness for embarkation.

No abstract

Recent statistics suggest that emigration from South Africa is accelerating while documented immigration remains at low levels. Primary analysis of a 10% sample of the overseas‐born in South Africa from the 1996 census confirmed that Black immigrants to South Africa were shown to be predominantly unskilled males, who were no better qualified than the Black population in general. This contrasts with the apartheid era when South Africa built up a stock of overseas‐born skilled workers, mostly Whites, which was not replenished in the 1990s, partly because of restrictive immigration policies. The UK is the major destination for South Africans but lacks detailed data on the characteristics of the immigrants. The second destination is Australia and New Zealand combined. Comparisons are made with published census data on the South Africa‐born in Australia and New Zealand. A majority of emigrants have post‐school qualifications and professional occupations, reflecting the selective immigration criteria of Australia and New Zealand. The analysis confirms the importance of human capital to potential emigrants even though they may wish to move for non‐economic reasons. It also supports the view that South Africa had moved from a brain exchange of Whites to a brain drain, thus compounding a national shortage of skilled workers. Copyright © 2006 John Wiley & Sons, Ltd.

Background: During ship transport of organic cargo e.g. soybeans in bulk or textiles in containers, there is a risk of pests damaging the cargo during transport as well as of unwanted global spread of organisms. Consequently, fumigation of the shipped goods is recommended. While aiming to protect the cargo from being damaged by pests during the transport time, fumigation constitutes a risk to the health of seafarers and port workers and even fatal cases are seen. Phosphine gas is increasingly applied for fumigation. Based on former experiences this article aims to describe the risk and to provide recommendations for prevention. Materials and methods: All reports of acute occupational exposures to phosphine in the maritime shipping industry to the Belgian Poison Centre were analysed and compared to reports in a study by ANSES (Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail), which collected data from the French Poison Centres. Data were registered and analysed between the 1 st of January 1999 and the 31 of December 2018. Results: The reported incidents have so far been rather few but seem to have increased over the last years. Symptoms are gastro-intestinal, neurologic and respiratory and often seem "vague" and non-specific and are often difficult to recognise for first responders. In the cases where the aetiology of the incident is known, there often seems to be a lack of clear information about the risk and options for mitigation in workplaces and among the workers. Twelve publications of case reports were included from the literature review that showed the same patterns as found in the registered incident reports. Conclusions: There seems to be an increase in incidents of acute poisoning from phosphine worldwide. This increase could be linked to the phasing out of methyl bromide in the Montreal Protocol but may also have other explanations. Strict precautions are needed when using phosphine for fumigation of ship cargoes and containers. Since symptoms are often vague, first-responders need to pay attention to the possible occurrence of acute phosphine intoxication as it may be life threatening. Phosphine intoxication remains a diagnosis nor to underestimate not to miss. Further monitoring and research is needed. Preventive actions are mandatory. It is essential to implement in a strict way the existing legislation of an in-transit fumigation with phosphine. Training of the crew and good communication between the different actors during an in-transit fumigation (ship-owner, captain, fumigator, crew, longshoremen) is the key of a good prevention of accidents.